Provider Demographics
NPI:1578370961
Name:PERCZAK, SARAH JEAN (PPS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:PERCZAK
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:VANSANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PPS
Mailing Address - Street 1:777 E TACHEVAH DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4903
Mailing Address - Country:US
Mailing Address - Phone:760-416-8190
Mailing Address - Fax:
Practice Address - Street 1:777 E TACHEVAH DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4903
Practice Address - Country:US
Practice Address - Phone:760-416-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool